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The cities with the highest homicide rates are once again nearly all in Latin America, according to data from the Igarapé Institute, a Brazilian think-tank.

43 of the 50 most murderous cities in the world in the year 2016, and eight of the top ten countries, are in Latin America and the Caribbean. (War zones, where numbers are hard to verify, are excluded.)

The murders are attributed to conflicts between gangs, weak public institutions and high levels of corruption across the region. South America remains the world’s leading producer of cocaine and it is trafficked to the world’s leading market; United States via Central America and the Caribbean.

The land routes originate mainly in Colombia, and pass through the small nations of El Salvador, Honduras and Guatemala before traversing Mexico. It is little wonder, then, that Latin America remains the world′s most violent region not at war. The top of the rankings has not changed. In both 2015 and 2016, El Salvador was the world′s most violent country, and its capital, San Salvador, was the most murderous city.

Only two countries outside Latin America contain cities in the top 50: the United States and South Africa. South Africa is the only country outside the Americas on the ranking. Two new cities, Nelson Mandela Bay and Buffalo City, have been added to the list, mainly because data collection is improving in the country. The homicide rate in South Africa did climb 5% in 2016, though other violent crime dropped.